Organization
COLLABORATIVE HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE CONNER DC (PRESIDENT)
(803) 359-2273
Entity
Organization
Contact information
Practice address
716 OLD CHEROKEE RD, LEXINGTON, SC 29072-9406
(803) 359-2273
(803) 359-3497
Mailing address
716 OLD CHEROKEE RD, LEXINGTON, SC 29072-9406
(803) 359-2273
(803) 359-3497
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
06/05/2013
Last updated
06/05/2013
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